Takeaway
- Longer diabetes duration and poor glycaemic control (high glycated haemoglobin [HbA1c] levels) were associated with increased risks of cardiovascular disease (CVD) and all-cause mortality.
- Combination of longer diabetes duration and poor glycaemic control conferred the greatest risks.
Why this matters
- Physicians should consider these 2 conditions together as part of CVD risk assessments for patients with diabetes.
Study details
- Prospective cohort analysis of 435,679 participants without CVD (with diabetes, n=21,109; without diabetes, n=414,570) from the UK Biobank.
- Funding: supported by the Open Project of Guangdong Provincial Key Laboratory of Tropical Disease Research.
Key results
- Longer diabetes duration was associated with higher risks of CVD and all-cause mortality.
- Compared with diabetes duration of <5 year, the adjusted HRs (aHRs, 95% CIs) for diabetes durations of 5 to <10 years, 10 to <15 years and ≥15 years were 1.15 (0.99-1.34), 1.50 (1.26-1.79) and 2.22 (1.90-2.58), respectively, for fatal/non-fatal CVD.
- The corresponding aHRs (95% CIs) were 0.86 (0.65-1.12), 1.56 (1.18-2.08) and 2.05 (1.58-2.66), respectively, for fatal CVD and 1.15 (1.04-1.27), 1.35 (1.19-1.53) and 1.71 (1.53-1.92), respectively, for all-cause mortality.
- HbA1c ≥8% vs <7% was associated with an increased risk of (aHR; 95% CI):
- fatal/non-fatal CVD (1.67; 1.45-1.92);
- fatal CVD (1.68; 1.32-2.13); and
- all-cause mortality (1.40; 1.26-1.55) (Ptrend for all <.001).
- Patients with diabetes duration of ≥15 years and HbA1c ≥8% vs those with diabetes duration of <5 years and HbA1c <8% had the highest risks of (aHR; 95% CI):
- fatal/non-fatal CVD: 3.12; 2.52-3.86;
- fatal CVD: 3.24; 2.29-4.57; and
- all-cause mortality: 2.48; 2.12-2.90.
Limitations
- Limited generalisability.
- Risk of inaccuracy in calculating diabetes duration.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.